Korean Journal of Nephrology 2008;27(5):569-575.
Changes in Skin Color in Hemodialysis Patients According to Dialysis Modality
Chan Ho Kim, M.D., Shin-Wook Kang, M.D., Sung Jin Moon, M.D., Kwang Il Ko, M.D., Dong Hyun Kim, M.D., Eun Young Kim, M.D., Jung Tak Park, M.D., Tae Ik Chang, M.D., Hyun Wook Kim, M.D., Sun Young Park, M.D., Jae Hyun Chang, M.D., Dong Ki Kim, M.D., Tae-Hyu
Department of Internal Medicine Yonsei University College of Medicine, Seoul, Korea
원저 : 혈액투석을 시행받고 있는 말기 신부전증 환자에서 투석 방법에 따른 피부색의 변화
김찬호, 강신욱, 문성진, 고광일, 김동현, 김은영, 박정탁, 장태익, 김현욱, 박선영, 장제현, 김동기, 유태현, 한대석
연세대학교 의과대학 내과학교실
Abstract
Purpose : Skin hyperpigmentation in end stage renal disease patients is known to be attributed to the accumulation of middle molecular weight (MMW) substances such as urochromic pigments and carotenoids. Therefore, there is a possibility that hyperpigmentation may be improved by high-flux hemodialysis (HF-HD) and online hemodiafiltration (HDF). This prospective study was undertaken to investigate the quantitative changes in skin color in HD patients according to dialysis modality. Methods : Eighty-two stable ESRD patients undergoing HD were enrolled and divided into three groups according to their dialysis modality. Melanin index and erythema index of forearm and abdomen (nonsun exposed area), and forehead (sun exposed area) were measured by narrow-band reflectance spectrophotometer at baseline and after 12 months. Results : There were no significant differences in the baseline values of melanin and erythema indices among the three groups. But the changes in forehead melanin index were significantly lower in HDF patients (-1.0±2.4%) compared to the LF-HD group (0.3±1.6%) (p<0.05), and forehead erythema index was significantly decreased in patients treated by HDF (-1.6±2.5%) relative to the lowflux hemodialysis group (-0.1±2.5%) (p<0.05). Conclusion : The changes in skin color of sun exposed area were reduced by HDF, suggesting that enhanced removal of MMW substances by convective therapy may be of advantage to skin hyperpigmentation in ESRD patients.
Key Words: Dialysis, Hyperpigmentation, Hemodiafiltration


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